Nyhuis Peter W
Klinik für Psychiatrie und Psychotherapie, Universität Duisburg-Essen.
MMW Fortschr Med. 2006 Jan 26;148(4):26-8, 30.
After the remission of a depressive episode, the antidepressant should be continued at the same dose level for at least six months to prevent a relapse. Following severe, therapy-refractive depression, or if the course of the disease reveals an increased tendency to relapse, a phase-prophylactic long-term treatment is recommended. In the treatment of unipolar depressive disorders, lithium and antidepressant agents applied at the dosage effective for acute treatment are equally effective. The more severe the successfully treated depression, or the greater the risk of a relapse, the longer the prophylactic treatment should be. Current data show that interpersonal psychotherapy and cognitive-behavioral therapy are also of value in preventing a relapse. An independent suicide-preventing effect is to be seen with lithium, and presumably also with clozapine.
抑郁发作缓解后,抗抑郁药应维持相同剂量至少六个月以预防复发。对于严重的、难治性抑郁症,或如果病程显示复发倾向增加,则建议进行阶段性预防性长期治疗。在治疗单相抑郁症时,锂盐和以急性治疗有效剂量应用的抗抑郁药同样有效。成功治疗的抑郁症越严重,或复发风险越大,预防性治疗就应持续越长时间。目前的数据表明,人际心理治疗和认知行为治疗在预防复发方面也有价值。锂盐有独立的预防自杀作用,氯氮平可能也有。